What is drinking a lot, how to drink moderately or not to drink at all - what to choose?
In our society, there is an ambivalent attitude towards alcohol and its consumption: on the one hand, "drinking is harmful to health! ", And on the other hand, "who doesn't drink now? ". In our opinion, this is due to the fact that alcohol consumption is often considered by medicine from two extreme positions: norm (sobriety) and disease (alcohol dependence). At the same time, teetotalers are a minority in society: from 40% of the general population (including minors and adults) to 10-15% of the adult population. In this regard, many people have a question: "Is drinking alcohol so harmful if it is so common, and the very doctors who constantly talk about its harm are hardly teetotalers? ""That is why the purpose of this article is not only to talk about the real dangers and harms of excessive alcohol consumption, but also about what constitutes its consumption with minimal health risk.
Let's start with some important definitions. What is alcohol consumption, abuse and alcohol dependence? In itself, the consumption of alcohol, like many other substances, is a type of human behavior. The difference between alcohol (and tobacco) and many other food products is related to its ability to influence a person's mental activity: emotions, behavior, thinking. Alcohol therefore refers to psychoactive (psychoactive) substances, which also include narcotics (opioids, psychostimulants and cannabis), psychotropic drugs (barbiturates, benzodiazepines) and toxic substances (glue, petrol, solvents). Alcohol and most psychoactive substances can cause abuse and dependence in humans. Abuse is understood as a type of consumption that damages a person's physical (high blood pressure, damage to the liver, heart and nerves) and mental health (insomnia, depression, anxiety), and can also disrupt the professional (dismissal), family (divorces, scandals) and public (arrests, drunk driving) life of a person.
Abuse is already a painful condition and requires the intervention of a doctor, but, importantly, at this stage it can also be a general therapist or neurologist who has skills in short-term intervention for alcohol problems. Alcohol addiction is already a disease, similar to anxiety or depression, in the presence of which a person needs the help of other doctors - a narcologist or a psychotherapist.
Alcohol dependence involves a combination of disturbances in behavior, thinking and physical functions of the body that develop after repeated use of alcohol. The main symptoms of alcohol addiction are a strong compulsion to "drink" ("thirsty"); violation of the ability to control alcohol intake (the beginning and end of drinking and the dose) ("no brakes, partying"); desire or unsuccessful attempts to reduce or control drinking; withdrawal state (withdrawal syndrome, "waste"), when you stop or reduce the intake of alcohol and relieve this condition when you drink; tolerance - gradually increasing the dose of alcohol consumed; ignoring other interests and increasing the time of drinking; and finally, the continuation of drinking with their obvious harm to health. An addiction diagnosis can be made if three or more of these signs are present within one month of the past year (eg, weekly one-day heavy drinking on a Friday after work or four weekly binges per year).
If in society 5 to 10% of the population abuse alcohol and another 4% of the population (2% of women and 6% of men) are dependent on alcohol, then among the rest of the population about 10-20% more detection of excessive consumptionof alcohol. According to the WHO definition, excessive (hazardous or risky) alcohol consumption is considered to be those levels or types of alcohol that, if continued, will lead to harm to health (that is, what will later become abuse).
It is now believed that the amount of alcohol consumed directly determines the likelihood of developing various alcohol problems (hazardous consumption, abuse and dependence), after which it may be necessary to stop binge drinking. Adults who do not drink alcohol have been shown to consume no more than 20g of ethyl alcohol per day to minimize the risk of developing problems. At the same time, alcohol intake should be no more than 5 days a week with mandatory 2 sober days. According to WHO, 10 g of ethyl alcohol is considered as 1 standard unit (dose) of alcohol. One dose of alcohol is contained in 330 ml. beer with a strength of 5%; in 140 ml. dry wine (9-11%); in 70 ml. fortified wine (18%); and in 35 ml of alcohol (40%). To calculate the amount of ethyl alcohol in grams in an alcoholic drink, it is necessary to multiply the volume of the drink by its strength and by a conversion factor of 0. 79 (each milliliter of pure ethyl alcohol contains 0. 79 g).
However, in some situations even taking one or two doses of alcohol a day is undesirable: if you drive, if you are pregnant or breastfeeding, when you take certain medications, with many diseases and when you cannot control your drinking (ie you haveone of the signs of addiction).
What problems does alcohol cause?
Alcohol problems are not only harmful to health and psyche, but also various professional, family and social consequences of excessive drinking.
A low risk of alcohol problems is seen at 3-4 drinks per day for men (20 per week) and 2-3 for women (15 drinks per week). The average risk of problems is seen at 25-35 doses per week for men and 15-25 doses for women. A high risk of alcohol problems is seen when drinking more than 35 drinks a week for men and more than 25 for women. A further increase in consumption indicates abuse and sharply (6. 5 times) increases the risk of developing alcohol dependence and related somatic diseases. Thus, you can calculate the amount of alcohol drunk in the last 7 days, which can be considered an indicator of the average alcohol consumption in general. And then you can assess how much risk drinking brings you, and also whether it's already painful.
In addition to the amount of alcohol consumed, the likelihood that an individual will develop alcohol abuse and dependence is also influenced by hereditary, personal, and social factors; they are also called risk factors. Hereditary (genetic) risk factors include alcohol dependence of parents (risk increases 3-4 times) and other addictions (drug addiction - risk increase by 4-5 and mother's smoking - by 2-3 times). Currently, many genes have been identified that are responsible for the development of alcohol dependence, but they determine only 30-40% of the risk of its occurrence. These. 60-70% of the risk of alcoholism depends on the person's personality and environment.
Genetic differences also influence people's physiological and psychological characteristics regarding alcohol consumption. The following characteristics were revealed: a) abnormal (slow or accelerated) metabolism (processing) of ethanol - "I get drunk quickly or completely"; b) accelerated development of tolerance - "does not accept vodka"; c) altered reactions to alcohol (irritability, aggression and depression).
What characteristics of a person increase the risk of developing alcohol dependence? The main ones are male gender, early first drinking, young age (16-19 years), living outside marriage (single, divorced or widowed), low income, not working, retirement. Psychological problems that often predispose to the development of alcohol dependence at a young age (before 25 years) are emotional instability (mood changes, irritability, aggressive behavior), altered drunkenness, hyperactivity and risky behavior (stimulus-seeking behavior - gambling, manysexual relations). partners), as well as higher levels of alcohol consumption at an early age.
Psychological problems that often predispose to the development of alcohol dependence in adulthood (after 30 years) are increased levels of anxiety and depression, impaired ability to communicate (shyness), difficulty with change, fear of being abandoned, avoiding problems, lack of meaning for existence and prospects. Social risk factors for alcoholism include a high level of stress in the family for women and stress at work for men, low social status of the family (poverty, poor housing conditions), disruption of the structure and functioning of the family (incomplete - for women).
What can be advised to a person who drinks alcohol moderately, but has risk factors for developing alcohol dependence, i. e. can become an alcoholic?
In these people, even moderate-risk alcohol consumption can cause the same problems as low-risk alcohol consumption in people without these factors. Therefore, they must prevent the development of alcohol abuse and dependence, and this can only be achieved by constantly observing the limits of moderate alcohol consumption. Even single doses of high doses of alcohol (more than 5 doses per day) can contribute to the development of alcohol problems related to intoxication - poisoning, injuries, accidents, violence; and long-term consumption of even small amounts of alcohol (3-5 drinks per day) increases the risk of addiction by 2-3 times compared to those without these hereditary, personal and social risk factors. Therefore, excess doses are unacceptable for them.
What can be advised to a person who drinks alcohol in moderation and has no risk factors for developing alcohol dependence, but nevertheless risks becoming an alcoholic? In such people, while maintaining the same level of alcohol consumption, the risk of developing addiction is minimal. However, if they are exposed to unfavorable external (dismissal, divorce, retirement) or internal factors (illness, anxiety and depression), as well as if they allow alcohol excesses (taking large amounts of alcohol - more than 5 doses per day for 3-7days) or increase the amount of alcohol regularly consumed, addiction and abuse may develop in a short time.
Finally, what advice can be given to a person who consumes alcohol in dangerous or harmful amounts? What should I say to such a patient? The advice is quite simple – try to drink less, or if that doesn't help, stop drinking alcohol. How to drink less? Dilute alcoholic drinks, replace alcohol with non-alcoholic drinks; eat before and after drinking. Try to distract yourself from the glass and drink more slowly; do something else to drink less; start later than usual; do alcohol fasting days: two or three or even four days a week are better. Try not to get into high-risk situations where you can lose control: in campaigns, with friends, after work, on holidays, after pay, on weekends. Try not to drink when you are bored or lonely, irritated, tense and in a bad mood, with insomnia and anxiety; and if you find yourself in such a situation - leave, refuse. Try other forms of entertainment and recreation; and most importantly, learn to say no. It is important to find people who drink moderately and are willing to support you in your efforts to resolve your alcohol problems.
The last question that this article will try to answer is: what should a person and his loved ones do with an already existing dependence on alcohol (alcoholism)?
Stopping consumption is necessary if you experience a frequent desire to drink (even for the purpose of relaxation, stress relief, entertainment); you can't control how much you drink you suffer from a hangover the next day after heavy drinking and you need a drink to improve your well-being; You need more and more alcohol to get drunk or to return to "normal". It is also necessary to stop drinking if you suffer from high blood pressure (alcohol does not cure the pressure, on the contrary, it increases the risk ofhypertensive crises and strokes), liver disease, pancreatitis, and you are taking drugs that are incompatible with alcohol (antibiotics, heart drugs, pressure drugs, etc. ). If you cannot give up on your own, then do not despair, now there are enough qualifiedspecialists - psychotherapists and narcologists, who anonymously: without registration, job advertisement and driver's license suspension, will provide you with effective help. The main thing to remember is that alcoholism is treatable, but the result of its treatment is not recoveryof "the ability to drink again in the company like everyone else is 100 grams", and the effective preservation of sobriety for a long time.